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221 George St Beckley WV 25801-2609 | |
| (304) 228-1955 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 221 George St, Beckley, West Virginia |
| Authorized Official Name and Position | Sharon M Smith (OWNER) |
| Authorized Official Contact | 3042281955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
221 George St Beckley WV 25801-2609 Ph: (304) 228-1955 | 221 George St Beckley WV 25801-2609 Ph: (304) 228-1955 |
| NPI Number | 1881455210 |
|---|---|
| Provider Enumeration Date | 01/22/2024 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 6709224009 |
|---|---|
| Medicare Enrollment ID | O20240405001108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881455210 | NPI | - | NPPES |
| Provider Name | Tanya M Lilly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255547816 PECOS PAC ID: 8022314913 Enrollment ID: I20160302001032 |
| Provider Name | Sara Frost |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427406412 PECOS PAC ID: 1658781109 Enrollment ID: I20240826001296 |
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